| National Provider Identifier [NPI]: | 1255382529 |
| Last Name Of The Provider | LETZER |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 S SUNNY SLOPE RD STE 136 |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROOKFIELD |
| Zip Code Of The Provider | 530054858 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 5418 |
| Number Of Medicare Beneficiaries | 790 |
| Total Submitted Charge Amount | 508468.77 |
| Total Medicare Allowed Amount | 203741.45 |
| Total Medicare Payment Amount | 155041.5 |
| Total Medicare Standardized Payment Amount | 161519.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 3503 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 3525.57 |
| Total Drug Medicare AllowedAmount | 2455.88 |
| Total Drug Medicare PaymentAmount | 1933.71 |
| Total Drug Medicare Standardized Payment Amount | 1933.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 1915 |
| Number Of Medicare Beneficiaries With Medical Services | 790 |
| Total Medical Submitted Charge Amount | 504943.2 |
| Total Medical Medicare Allowed Amount | 201285.57 |
| Total Medical Medicare Payment Amount | 153107.79 |
| Total Medical Medicare Standardized Payment Amount | 159585.88 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 146 |
| Number Of Beneficiaries Age 65 to 74 | 271 |
| Number Of Beneficiaries Age 75 to 84 | 234 |
| Number Of Beneficiaries Age Greater 84 | 139 |
| Number Of Female Beneficiaries | 404 |
| Number Of Male Beneficiaries | 386 |
| Number Of Non Hispanic White Beneficiaries | 739 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 623 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 167 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 59 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.6034 |